APPENDIX I: CHECKLISTS

							                                                   STAGE 0
                                  Preliminary Scope and Budget Checklist
                                    MPO Area:
A.      Project Background
District                                              Parish
Route
Project Category (Safety, Capacity, etc.):
Date Study Completed:
Describe the existing facility:
Functional classification:                                       Number and width of lanes:
Shoulder width and type:                                         Mode:
Access control:                      ADT:                                 Posted Speed:
Describe any existing pedestrian facilities (ADA compliance should be considered for all improvements that
include pedestrian facilities):
Describe the adjacent land use:
Who is the sponsor of the study?
List study team members:
Will this project be adding miles to the state highway system (new alignment, new facility)? If yes, has a
transfer of ownership been initiated with the appropriate entity?
Are there recent, current or near future planning studies or projects in the vicinity?
If yes, please describe the relationship of this project to those studies/projects.

Provide a brief chronology of these planning study activities:



B.      Purpose and Need
State the Purpose (reason for proposing the project) and Need (problem or issue)/Corridor Vision and a brief
scope of the project. Also, identify any additional goals and objectives for the project.




C.      Agency Coordination
Provide a brief synopsis of coordination with federal, tribal, state and local environmental, regulatory and
resource agencies.




What transportation agencies were included in the agency coordination effort?


Describe the level of participation of other agencies and how the coordination effort was implemented.




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Stage 0 Preliminary
Scope and Budget Checklist

C.       Agency Coordination (Continued)
What steps will need to be taken with each agency during NEPA scoping?




D.       Public Coordination
Provide a synopsis of the coordination effort with the public and stakeholders; include specific timelines,
meeting details, agendas, sign-in sheets, etc. (if applicable).




E.       Range of Alternatives – Evaluation and Screening
Give a description of the project concept for each alternative studied.
What are the major design features of the proposed facility (attach aerial photo with concept layout, if
applicable).




Will design exceptions be required?
What impact would this project have on freight movements?


Does this project cross or is it near a railroad crossing?
Was the DOTD’s “Complete Streets” policy taken into consideration?
    If so, describe how. Include a brief explanation of why the policy was determined to be feasible or not
        feasible.



How are Context Sensitive Solutions being incorporated into the project?



Was the DOTD’s “Access Management” policy taken into consideration? If so, describe how.


Were any safety analyses performed? If so describe results.

Are there any abnormal crash locations or overrepresented crashes within the project limits?


What future traffic analyses are anticipated?



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                                                  Revised July 2011
Stage 0 Preliminary
Scope and Budget Checklist

E.       Range of Alternatives – Evaluation and Screening (Continued)
Will fiber optics be required? If so, are there existing lines to tie into?
Are there any future ITS/traffic considerations?


Is a Transportation Management Plan (TMP) required?
      Is this project considered significant as defined in EDSM No. VI.1.1.4?
      If yes, describe the mobility and safety analysis and assessment that was conducted as required in the
         development of a TMP.

        What further data will need to be collected to address the content and scope of the TMP in the design
         stage/phase of this project?


Was Construction Transportation Management/Property Access taken into consideration?
Were alternative construction methods considered to mitigate work zone impacts?
Describe screening criteria used to compare alternatives and from what agency the criteria were defined.



Give an explanation for any alternative that was eliminated based on the screening criteria.




Which alternatives should be brought forward into NEPA and why?




Did the public, stakeholders and agencies have an opportunity to comment during the alternative screening
process?
Describe any unresolved issues with the public, stakeholders and/or agencies.




F.       Planning Assumptions and Analytical Methods
What is the forecast year used in the study?
What method was used for forecasting traffic volumes?
Are the planning assumptions and the corridor vision/purpose and need statement consistent with the long range
transportation plan?
What future year policy and/or data assumptions were used in the transportation planning process as they are
related to land use, economic development, transportation costs and network expansion?




G.       Potential Environmental Impacts
See the attached Stage 0 Environmental Checklist
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                                                  Revised July 2011
Stage 0 Preliminary
Scope and Budget Checklist

H.        Cost Estimate
Provide a cost estimate for each feasible alternative:

                                      Total              Funding Source
                                                     (STP>200K, STP<200K,      Match Provided By              TIP Fiscal
               Phase                Estimated                                 (City, Parish, State, Other…)
                                                      CMAQ, DEMO, DOTD                                          Year
                                      Cost              Priority Program)
        Environmental
     (document, mitigation, etc.)

     Engineering Design
       R/W Acquisition
        (C of A if applicable)

      Utility Relocations

          Construction
 Construction Engineering
  & Inspection Services
        TOTAL COST

ATTACH ANY ADDITIONAL DOCUMENTATION

Disposition (circle one): (1) Advance to Stage 1         (2) Hold for Reconsideration      (3) Shelve




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                                                 Revised July 2011